ETIOLOGICAL PROFILE OF CHILDREN ADMITTED WITH FEVER WITHOUT FOCUS FOR LESS THAN 7 DAYS DURATION AT TERTIARY CARE CENTER

Objective: The objective of the study was to know about the etiology of acute undifferentiated febrile illness (AUFI) or fever without focus in children admitted at tertiary care hospital. Methods: A study was conducted at medical college, Jhalawar, for a period of 3 months. Pediatric patients presenting with fever for less than or equal to 7 days duration without focus, who required hospitalization were included in this study. Results: A total of 200 children enrolled in study. Male-to-female ratio was 1.9:1. Mean age of children was 7.21±4.2 years. About 142 (71%) patients presented after 3 days of fever. Average duration of fever before admission was 4.62±1.78 days. The most common cause of fever of short duration (less than 7 days) was dengue fever 74 (37%) followed by malaria 58 (29%) and typhoid fever 36 (18%). About 26 (13%) patients had mixed infection. Out of 200 patients, 70 (35%) patients had splenomegaly, 66 (33%) had hepatomegaly, and 26 (13%) patients had both hepatosplenomegaly. Conclusion: The common etiology of AUFI with short duration in children was dengue, malaria, and typhoid. Vector control measures, drinking water supply, and sanitation should be improved to prevent vector-borne and water-borne diseases

The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

Aim To study the role of Doppler imaging in prediction of high-risk pregnancies and their outcomes. Methods and Material This prospective study in a setup of tertiary-level care center includes 500 high-risk pregnant women from rural and urban sectors and evaluates the predictive values of various Doppler indices. Results Out of 500 patients, 110 patients had abnormal Doppler among them, 70 patients had abnormal uterine artery Doppler, and 50 patients had abnormal umbilical artery Doppler flow indices. In all, 10 patients had both umbilical artery and uterine artery abnormal Doppler indices. When uterine artery was abnormal (70 patients), 20 patients had preeclampsia, 10 patients had pregnancy-induced hypertension (PIH), and 25 patients had intrauterine growth restriction (IUGR). Systolic/diastolic (S/D) ratio and notch had sensitivity of 60% and positive predictive value of 33.3% and 37.5%, respectively. When umbilical artery was abnormal (50 patients), 10 had preeclampsia, 15 had PIH, and 15 had IUGR. S/D ratio had the highest positive predictive value of 40%; sensitivity is same for all. In uterine artery, combination of parameters had the best sensitivity of 80%, followed by notch and S/D ratio. In umbilical artery, combination of parameters, S/D ratio, and RI (resistance index) had sensitivity of 40%; specificity of all the indices was 91-96%. In all, 20 patients had bilateral notch, and among them 15 developed preeclampsia and 15 developed IUGR. When both uterine and umbilical artery Doppler were abnormal (10 patients), all patients had preeclampsia and IUGR. Conclusion Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality

Binding free energy calculation with QM/MM hybrid methods for Abl-Kinase inhibitor

We report a Quantum mechanics/Molecular Mechanics–Poisson-Boltzmann/ Surface Area (QM/MM-PB/SA) method to calculate the binding free energy of c-Abl human tyrosine kinase by combining the QM and MM principles where the ligand is treated quantum mechanically and the rest of the receptor by classical molecular mechanics. To study the role of entropy and the flexibility of the protein ligand complex in a solvated environment, molecular dynamics calculations are performed using a hybrid QM/MM approach. This work shows that the results of the QM/MM approach are strongly correlated with the binding affinity. The QM/MM interaction energy in our reported study confirms the importance of electronic and polarization contributions, which are often neglected in classical MM-PB/SA calculations. Moreover, a comparison of semi-empirical methods like DFTB-SCC, PM3, MNDO, MNDO-PDDG, and PDDG-PM3 is also performed. The results of the study show that the implementation of a DFTB-SCC semi-empirical Hamiltonian that is derived from DFT gives better results than other methods. We have performed such studies using the AMBER molecular dynamic package for the first time. The calculated binding free energy is also in agreement with the experimentally determined binding affinity for c-Abl tyrosine kinase complex with Imatinib